Clinical Spectrum of Complications Induced by Intravesical Immunotherapy of Bacillus Calmette-Guérin for Bladder Cancer

Liu, Yuqing; Lu, Jian; Huang, Yi; Ma, Lulin

doi:10.1155/2019/6230409

Cited by 55 publications

(56 citation statements)

References 76 publications

(94 reference statements)

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“…Most common side effects are related to inflammatory response within the bladder leading to chemical cystitis including dysuria, frequency, and hematuria. Direct contact of the BCG solution may lead to anterograde or retrograde spread of M. bovis and associated granulomatous inflammation to involve to the remainder of the genitourinary tract including the penis, epididymis, testis, prostate, and kidney [6] . In this case, spread of live attenuated M. bovis from the prostatic urethra through the vas deferens and ductus deferens into the epididymis and testes and caused epididymal and testicular TB.…”

Section: Discussionmentioning

confidence: 99%

“…Prostatitis and associated elevation of prostate-specific antigen levels is common after intravesical BCG therapy and may occur with an incidence of up to 10%. Tuberculous epididymo-orchitis is relatively uncommon and occurs in approximately 0.4% of patients [6] . Pyelonephritis and renal abscess are also less common at 0.3%.…”

Section: Discussionmentioning

confidence: 99%

“…Pyelonephritis and renal abscess are also less common at 0.3%. Systemic complications also occur infrequently at a rate of approximately 3% and include military TB, mycotic aneurysms, granulomatous hepatitis, tuberculous spondylitis, and BCG-related sepsis [6 , 7] .…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Testicular tuberculosis: An uncommon complication after treatment of urothelial carcinoma

Sadeghi

Chaikin

Calhoun

2020

Radiology Case Reports

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Tuberculous epididymo-orchitis is an uncommon complication after intravesical bacilli Calmette-Guerin therapy for nonmuscle invasive bladder cancer. Spread of granulomatous disease through the genitourinary tract specifically to the testes occurs in 0.4% of treated patients. The following case presents a 77-year-old man who underwent intravesical therapy after transurethral resection of bladder tumor and developed testicular discomfort and a palpable mass 2 years after initiation of therapy. After wide range of serum and urine analyses, repeated testicular ultrasonography, and an unsuccessful course of antibiotics, the patient elected to undergo orchiectomy and was confirmed to have tuberculous epididymo-orchitis. Diagnosis based on imaging and laboratory serum and urine analysis may be elusive and therefore review of this entity and associated sonographic findings is discussed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Testicular tuberculosis: An uncommon complication after treatment of urothelial carcinoma

Sadeghi

Chaikin

Calhoun

2020

Radiology Case Reports

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“…P25 developed uveitis and died due to a brain haemorrhage. Whether this could be a case of a rare complication due to BCG is unclear; there are 15 cases of ocular inflammation reported after intravesical BCG instillations, 4 of them with confirmed Mycobacterial invasion (Liu et al, 2019). The treatment course of P26 was complicated by fever and urinary tract infection.…”

Section: Urinary Cell Distribution Can Identify Patients With Unusualmentioning

confidence: 99%

CyTOF analysis identifies unusual immune cells in urine of BCG-treated bladder cancer patients

Castellano

Samba

Esteso

et al. 2020

Preprint

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Running title (40 ch): Urine immune cells after BCG treatmentAbstract (limit 175) (175) High grade non-muscle-invasive bladder tumours are treated with transurethral resection followed by recurrent intravesical instillations of Bacillus Calmette Guérin (BCG). Although bladder cancer patients respond well to BCG, important questions remain unanswered, including how to identify at early stages non-responder patients and patients at risk to abandon the treatment. Here, we analysed the cells released into the urine of bladder cancer patients longitudinally 3-7 days after BCG instillations. Mass cytometry (CyTOF) analyses revealed that most cells were granulocytes and monocytes rather than effector lymphocytes, and most expressed activation markers. A novel population of CD15 + CD66b + CD14 + CD16 + cells was very abundant in several samples and expression of these markers was confirmed using flow cytometry and qPCR. Samples of patients with a stronger inflammatory response contained more cells in urine; however, this was not due to haematuria, as the proportions of the cell populations observed were different from blood. We provide the proof-of-concept for a new approach to analyse samples that may help classify patients and identify those at risk of BCG infection and other unwanted BCG-related events.

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“…As a therapeutic medicine in NMIBC patients, BCG is considered safe, although several adverse events have been described in BCG-treated NMIBC patients. 8 Flulike symptoms and/or burning discomfort in the bladder occur in the majority of patients. In the EORTC trial, the overall rate of adverse events in BCG-treated patients was as high as 70%, with 8% of patients discontinuing the treatment due to toxicity.…”

Section: Safety and Efficacymentioning

confidence: 99%

<p>Bacillus Calmette-Guérin (BCG) Therapy for Bladder Cancer: An Update</p>

Guallar-Garrido

Julián

2020

ITT

122

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Physicians treating patients affected by nonmuscle-invasive bladder cancer (NMIBC) have been in shock during the last six years since manufacturing restrictions on the production of the first-option medicine, Mycobacterium bovis Bacillus Calmette-Guérin (BCG), have resulted in worldwide shortages. This shortage of BCG has led to a rethinking of the established treatment guidelines for the rationing of the administration of BCG. Some possible schedule modifications consist of a decrease in the length of maintenance treatment, a reduction in the dose of BCG in intravesical instillations or the use of different BCG substrains. All these strategies have been considered valuable in times of BCG shortage. In addition, the lack of availability of BCG has also led to the general recognition of the need to find new treatment options for these patients so that they are not dependent on a single treatment. Few alternatives are committed to definitively replacing BCG intravesical instillations, but several options are being evaluated to improve its efficacy or to combine it with other chemotherapeutic or immunotherapeutic options that can also improve its effect. In this article, we review the current state of the treatment with BCG in terms of all of the aforementioned aspects.

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Clinical Spectrum of Complications Induced by Intravesical Immunotherapy of Bacillus Calmette-Guérin for Bladder Cancer

Cited by 55 publications

References 76 publications

Testicular tuberculosis: An uncommon complication after treatment of urothelial carcinoma

Testicular tuberculosis: An uncommon complication after treatment of urothelial carcinoma

CyTOF analysis identifies unusual immune cells in urine of BCG-treated bladder cancer patients

<p>Bacillus Calmette-Guérin (BCG) Therapy for Bladder Cancer: An Update</p>

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